From Persecution to Prison - Bellevue/NYU Program for Survivors of ...

Volunteer visitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3Priest/chaplain/religious leader . . . . . . . . . . . . . . . . . .4Other (specify) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54. (If person did receive counseling ask): Do you think the counseling youreceived helped?Yes ...........1No............2Explain:5. During the time you have been in INS detention have you wanted medicationsfor problems such as feelings of sadness, nervousness or difficulty sleeping?Yes ...........1No............26. During the time you have been in INS detention have you requested medicationsfor problems such as feelings of sadness, nervousness or difficulty sleeping?Yes ...........1No............27. During the time you have been in INS detention , have you received any medicationsfor problems such as feelings of sadness nervousness or difficulty sleeping?Yes ...........1No............28. Do you think the medication helped?Yes ...........1No............2Explain:9. During the time that you have been in INS detention, have you had thoughtsof ending your life?Yes ...........1No............210. (if yes to 10 ask): Did you tell detention facility staff?Yes ...........1No............2If Yes How did they respond?If No Why not?11. During the time that you have been in INS detention, have you attemptedending your life?Yes ...........1No............212. To what extent do you think the stress of being in detention is responsible foryour thoughts and/or attempts at ending your life.Not at all a little quite a lot extremelyAPPENDIX B 215